Paediatric Genital Problems

Case Study One - Hydrocoeles

A right hydrocoele

Hydrocoeles transilluminate.

An encysted hydrocoele of the cord is sometimes confused with a hernia, as it can be firm and high on the cord. Discriminating features are that you can get above the encysted hydrocoele and it transilluminates. It is likely to resolve without treatment.

An encysted hydrocoele can look like a hernia but it is high, firm and you can get above it. It transilluminates.

A transilluminating left hydrocoele

hydrocoeles transilluminate

Looks like a hernia but transilluminated clearly - a hydrocoele

A right hydrocoele

Obvious hydrocoele when transilluminated

Hydrocoeles are cystic fluid collections that are either still communicating with the abdominal cavity or sealed off. They can be firm or soft and may surround the testis or be encysted in the cord.

They usually resolve by the age of 2 years and could be surgically corrected after that time if they are very large or appear to be causing discomfort. They are normally painless. Communicating hydrocoeles can vary in their size particularly with straining or crying.

Transillumination is the most useful clinical sign to show they are fluid filled and excludes a hernia.

Communicating hydrocoele